Monday, October 19, 2009

Dalai's Down Under!

I made it to Sydney without much trouble at all, but that 15 hour flight from LA did seem to go on and on and on. Business class on Delta was very nice, with each seat forming a little cubby or cocoon. The seat itself could recline to horizontal, and I actually did manage to sleep much of the way. I did try to stay awake long enough to crash about 10PM Australian time, so I'm really not doing bad at all at the moment.

Delta did indeed get me there, in comfort and style, although I do have to warn those of you who might follow about what could have been an "epic fail" on their part. There is this little thing called the "Electronic Travel Authority" (ETA) required for travel to Australia. I'm not sure what it accomplishes other than separating the traveller from $20 AU, but that's beside the point. You can't get a boarding pass without one, and I had no idea of its existence. There was no flagging at the time the ticket was purchased, nor when I tried to check in online, or even at the airport kiosk. Fortunately, the Delta agent told me I could do this via internet, and by that point, I already had my iPhone out and connecting to Australia. The ETA was purchased in 5 minutes, and I was on my way. What did we do before iPhones? It would have been nice if Delta had told me about this somewhere earlier in the process, which would have saved me a bit of anxiety.

Sydney is a spectacularly beautiful city, built around the harbour that started it all. The city itself is amazingly clean. The people are friendly as can be, and very accomodating. They do drive on the wrong side of the street. I'm not even sure which side of the sidewalk to walk on, so as not to reveal myself as a Yank.

Here I am on the obligatory harbour cruise:

The Sydney Opera House, actually a collection of three separate theaters, is probably the most recognizable structure in the world today.

Each half-shell, if you will, is a section of a sphere, rather like creatively slicing an orange:

The Harbour Bridge used to be Sydney's landmark, also known as the Coathanger. For $200, one can climb up to the top, where the flags are in the photo. I passed on this wonderful opportunity.

Today, I have some meetings with Healthinc clients and personnel. Tomorrow I head off to Brisbane for RANZCR.

By the way, it seems that the "other" Dalai will be headed down here shortly. . .

I wish I could be here to see His Holiness, but maybe another time.

I did meet with a few Australian radiologists here in Sydney, and they were quite gracious and friendly. Both owned imaging centers that would rival anything back home, with CT, MR, US, NM, Mammo, DEXA, and so on. One even had a SPECT/CT!

Rads here work very hard, reading significantly more studies than our very busy group back home. This may be due in part to having less vacation, but still the daily grind is impressive. They too have the joys of Cardiologists, although the turf issues are a bit less intense. There has, for example, been a much higher level of cooperation for things like CCTA's between the two.

PACS is becoming widespread, but there are some problems with its adoption. Bandwidth out to the clinicians is a severe problem, for example, and a 4 MB up-and-downlink costs something like $12,000 AU/year, although this was probably for a commercial-grade line. I get on my home system 6-10 MB down (but only 1MB up) for $89/month, not $1000! (I'm since informed that home-grade DSL should be rather similarly priced.

In many ways, the infrastructure here is about 6-7 years behind the US. Clinicians are only starting to buy the more advanced scanners (beyond CR and US), and this like we once were as well. In more urban areas, there is almost a glut of radiology services, and in fact one of the outpatient centers we visited today was right next door to another one! But, like Florida, give that a few years and things will likely shake out.

More to come! Tomorrow, Brisbane and RANZCR!


A Doc 2 Be said...

Glad you made it safely there!!

I never flew out of LA... those long haul flights are the bomb if you're in business... Did they give you Toberlone?

You can thank your formally platinum NWA friends for having those exact type of seats.

The Platinum members who participated in the study about 1.5 years ago were sworn to secrecy as to what we were testing.

Great fun - glad someone will get to enjoy the fruits of their labor!


A Doc 2 Be said...

Oh, btw, we ALL told NWA/Delta we did not like the partition thingies in the middle of the seats in business class because if you were traveling with a partner (spousal equiv., etc) you could easily hold hands, or what-not.

Are those little partition things removable or retractable?

P.S. There is only one REAL Dalai... that's you :)

DHS said...

Welcome to Sydney! I hope you'll have time to spend more time seeing the sights on your way home from the RANZCR CSM.

As for PACS & other infrastructure things: the hospital (in the sydney metropolitan area) that I'm currently rotated out to only has a 4 slice scanner, but we have PACS (I thought I hated AGFAWeb, but I hate centricityweb almost as much). Radiology cover is networked across multiple hospitals.

I get 12mb down / 1mb up DSL (home grade) for about what you are paying. Is that not good enough for home reads? I'm hoping it is so I can do on-call XR reviews from home next instead of driving into the hospital just to say there is no fracture.

Dalai said...

12 MB down is certainly adequate! In theory most well-written web PACS clients should be able to operate at 1 MB, but 2-4 is probably a reasonable minimum. Maybe bandwidth isn't as much of a problem as our host was experiencing.

Anonymous said...

You truly have THE Life! Being a PACs blogger isn't too bad after all:) - have an enjoyable and restful trip. God bless!